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68 Cards in this Set
- Front
- Back
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schizoprenia
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dz that produces multiple s/s involving thought, behavior, emotion and perception
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dopamine hypothesis
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an excess of dopamine to be the cause of schizoprenia
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glutamate
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dominant neurotransmitter in the cerebral cortex and one of its functions is to modulate dopamine activity
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characteristic symptoms
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delusions
hallucinations disorganized speech catatonic behavior negative symptoms |
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types of schizo
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catatonic
disorganized paranoid residual undifferentiated |
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most prominent symptoms of schizo
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hallucinations
delusions |
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catatonic
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marked pyschomotor disturbances
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disorganized
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marked incoherence with inappropriate responses
hypochondriacal behavior may be present |
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paranoid
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delusions of grandeur or persecution
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residual
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vague associations
illogical thinking withdrawal affect living skills impaired |
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undifferentiated schizo
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may incorporate prominent delusions, hallucinations, incoherence or grossly disorganized behavior
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2 major therapeutic approaches for trmt
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psychotherapy
pharmacotherapy |
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positive symptoms of schizo
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hallucinations
delusions thought disorders disorganized speech bizarre behavior insomnia combativeness |
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negative symptoms of schizo
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affective flatterning
alogia apathy amotivation anhedonia asocial behavior inattentiveness |
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traditional antipsychotic agts moa
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exert their eff by blocking dopamine activity
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high potentcy agents
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more extrapyramidal symptoms
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low potency agents
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more sedation
anticholinergic cardiovascular se |
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efficacy
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effective in treating + sx
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atypical agts
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address the - sx
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traditional agts adv eff
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not well tolerated
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properties of traditional antipsychotics
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phenothiazines
thioxanthenes butyrophenones dihydroindolone dibenzoxazepine |
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phenothiazines
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chlorpromazine
trifluoperazine thioridazine mesoridazine perphenazine fluphenazine |
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thixanthene
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thiothixene
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butyrophenone
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haloperidol
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dihydroindolone
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molindone
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dibenzoxazepine
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loxapine
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antiphyscotic side eff
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anticholinergic se
sedation rahs photosensitivity thermoregulation dysfxn lowered sz threshold orthostatic hypotension ECH chgs hyperprolactenemia elevated liver transaminases bld dyscrasia wgt gain sexual dysfxn extrapyramidal sx ocular opacities neuroleptic malignant sx |
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anticholinergic side eff
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blurred vision
constipation dry mouth urinary retention |
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pharmacotherapy for tardive dyskinesia
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reserpine
benzodiazepines baclofen valproic deriv vit e |
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acute dystonias
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involve sudden muscle spasms
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sudden muscle spasms
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torticollis
retrocollis oculogyric crisis trismus |
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torticollis
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neck twisted to side
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retrocollis
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neck/head pulled back
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trismus
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clenched jaw
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oculogyric crisis
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fixed upward gaze
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trmt acute dystonia
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anticholinergic agents
diphenhydramine benztropine |
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akathisia
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motor restlessness
inner tension agitation |
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akathisia trmt
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b blker
bzd anticholinergic agts |
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pseudoparkinsonism
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drug induced by dopamine blkade agts
shuffling gait masked faces cogwheel rigidity pill rolling tremor |
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dopamine blkade agts
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antipsychotics
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tardive dyskinesia
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latent extrapyrimidal eff generally not occurring for mos or yrs
characterized by abnormal movements that can occur in any part of the body incl face, tongue, shoulders, hips, extremitites, fingers and toes |
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2 general types of movements
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dystonic
choreoathetoid |
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dystonic
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fixed
held muscle |
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choreoathetoid
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writhing
rhythmic |
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td etiology
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movements thought to occur fr porlonged dopamine blkade -> upregulation of dopamine rec and inc sensitivity to dop stimulation
generation of free radicals from lipid peroxidation 2ndary to inc neurotransmitter turnover |
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prevention
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best measure against td prevention
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measurement toolsof td
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abnormal involuntary movement scale (aims)
dyskinesia indentification system condensed user scale (discus) applied at baseline and every 3-6mos |
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NMS
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neuroleptic malignant syndrome
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def of dms
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syndrome of extrapyrimidal eff, hyperthermia, altered consciousness and autonomic changes
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autonomic changes
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tachy
unstable bp diaphoresis incontinence |
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specific mgmt of nms
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dc antipsychotic
provide supportive measures dantrolene or bromocriptine |
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QTc prolongation
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inc the risk for fatal vent arrhy (torsades de pointes)
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list of atypical antipsychotics
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clozapine
risperidone olanzapine quetiapine ziprasidone |
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diff bet traditional and atypical agts blkage
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traditional - blk D2 rec
atypical - blk sertonin rec |
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extrapyrimidal se- atypical
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fewer than traditional
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elevations of prolactin
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not produced by atypical agts
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hyperprolatinemia
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traditional agts
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rec affinity for atypical
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5 ht rec
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clozapine
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refractory pts
eps/td free reserved as last line therapy due to inc incidence of agranulocytosis and frequent lab monitoring- cbc |
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ziprasidone inj
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only parenteral atypical agt
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rapid tranquilization
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reserved for acutely psychotic pts with agitation and aggression
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adv eff histamine
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sedation
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adv eff serotonin - 5ht
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wgt gain
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adv eff dopamine
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extrapyrimidal sx
hyperprolactenemia |
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adv eff muscarinic
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anticholinergic eff
cognitive/memory inpairment tachy |
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adv eff alpha 1
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orthostatic hypotension
reflex tachy |
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long acting
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fluphenazine
haldol |
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most common augmentative therapy
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addition of a mood stabilizer to the antipsychotic regimen
typically - valproic acid, cbz or lithium, bzd |
